Correlation of Vitamin D Level and Bone Mineral Density in Epilepsy Children Who Received Oral Antiepileptic Drug
DOI:
https://doi.org/10.3889/oamjms.2023.11005Keywords:
vitamin D[25(OH)D], bone mineral density, epilepsy, antiepileptic drugAbstract
BACKGROUND: Vitamin D plays an essential role in achieving adequate bone mineralization. Antiepileptic drug (AED) will cause a change in calcium serum levels and bone mineral density (BMD) through increase catabolism of Vitamin D in the liver, as well as having a direct effect on the bone.
AIM: The aimed of this study was to know the correlation of Vitamin D [25(OH)D] level and BMD in epilepsy children who received oral AED.
METHODS: This cross-sectional study was conducted from May to September 2016. Subjects were collected using consecutive sampling in 1−11-year-old epilepsy children who went to the pediatric Neurology and Endocrinology outpatient clinic at Sanglah Hospital. Age, sex, body weight, body height, type and number of AED used, and duration of treatment were recorded. Measurement of 25(OH)D level and BMD was performed. Pearson test was used to analyze the strength of correlation based on normality test result.
RESULTS: Thirty subjects were collected, male (19/63.33%), mean age was 7.22 years, mean treatment duration was 1.71 years. Type of AED was inducer AED (18/60%) and non-inducer AED (12/40%). Mean Vitamin D level was 27.19 ng/mL and mean BMD was 0.78 g/cm2. Partial correlation test of Vitamin D level with BMD after controlling age found r = 0.118 with p = 0.54.
CONCLUSION: There was weak correlation between Vitamin D level and BMD in epilepsy children who received oral AED, but the correlation analysis was not sufficient to prove the relationship.
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Shakirullah, Ali N, Khan A, Nabi M. The prevalence, incidence and etiology of epilepsy. Int J Clin and Exp Neurol. 2014;2(2):29- 39. https://doi.org/10.12691/ijcen-2-2-3
Ecevit C, Aydoğan A, Kavakli T, Altinöz S. Effect of carbamazepine and valproate on bone mineral density. Pediatr Neurol. 2004;31(4):279-82. https://doi.org/10.1016/j.pediatrneurol.2004.03.021 PMid:15464641 DOI: https://doi.org/10.1016/j.pediatrneurol.2004.03.021
Nicholas JM, Ridsdale L, Richardson MP, Grieve AP, Gulliford MC. Fracture risk with use of liver enzyme inducing antiepileptic drugs in people with active epilepsy: Cohort study using the general practice research database. Seizure. 2013;22(1):37-42. https://doi.org/10.1016/j.seizure.2012.10.002 PMid:23127777 DOI: https://doi.org/10.1016/j.seizure.2012.10.002
Krishnamoorthy G, Karande S, Ahire N, Mathew L, Kulkarni M. Bone metabolism alteration on antiepileptic drug therapy. Indian J Pediatr. 2009;76(4):377-83. https://doi.org/10.1007/s12098-009-0005-5 PMid:19205634 DOI: https://doi.org/10.1007/s12098-009-0005-5
Salimipour H, Kazerooni S, Seyedabadi M, Nabipour I, Nemati R, Iranpour D, et al. Antiepileptic treatment is associated with bone loss: Difference in drug type and region of interest. J Nucl Med Technol. 2013;41(3):208-11. https://doi.org/10.2967/jnmt.113.124685 PMid:23886631 DOI: https://doi.org/10.2967/jnmt.113.124685
Lee HS, Wang SY, Salter DM, Wang CC, Chen SJ, Fan HC. The impact of the use of antiepileptic drugs on the growth of children. BMC Pediatr. 2013;13:211. https://doi.org/10.1186/1471-2431-13-211 PMid:24354857 DOI: https://doi.org/10.1186/1471-2431-13-211
Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M, Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: Review of current knowledge and recommendations. Pediatrics. 2008;122(2):398-417. https://doi.org/10.1542/peds.2007-1894 PMid:18676559 DOI: https://doi.org/10.1542/peds.2007-1894
Rafiq M, Bano S, Tariq PA. Effects of antiepileptic drug therapy on 25OH Vitamin D levels. Pak J Physiol. 2015;11(4):24-6.
Winzenberg T, Powell S, Shaw KA, Jones G. Effects of Vitamin D supplementation on bone density in healthy children: Systematic review and meta-analysis. BMJ. 2011;342:c7254. https://doi.org/10.1136/bmj.c7254 PMid:21266418 DOI: https://doi.org/10.1136/bmj.c7254
Grant WB, Holick MF. Benefits and requirements of Vitamin D for optimal health: A review. Altern Med Rev. 2005;10(2):94-111. PMid:15989379
Binkovitz LA, Henwood MJ. Pediatric DXA: Technique and interpretation. Pediatr Radiol. 2007;37(1):21-31. https://doi.org/10.1007/s00247-006-0153-y PMid:16715219 DOI: https://doi.org/10.1007/s00247-006-0153-y
Zerwekh JE. Blood biomarkers of Vitamin D status. Am J Clin Nutr. 2008;87(4):1087S-91S. https://doi.org/10.1093/ajcn/87.4.1087S PMid:18400739 DOI: https://doi.org/10.1093/ajcn/87.4.1087S
Schwartz JB, Lai J, Lizaola B, Kane L, Markova S, Weyland P, et al. A comparison of measured and calculated free 25(OH) Vitamin D levels in clinical populations. J Clin Endocrinol Metab. 2014;99(5):1631-7. https://doi.org/10.1210/jc.2013-3874 PMid:24483159 DOI: https://doi.org/10.1210/jc.2013-3874
Fuleihan GE, Dib L, Yamout B, Sawaya R, Mikati MA. Predictors of bone density in ambulatory patients on antiepileptic drugs. Bone. 2008;43(1):14955. https://doi.org/10.1016/j.bone.2008.03.002 PMid:18467202 DOI: https://doi.org/10.1016/j.bone.2008.03.002
Gniatkowska-Nowakowska A. Fractures in epilepsy children. Seizure. 2010;19(6):3245. https://doi.org/10.1016/j.seizure.2010.04.013 PMid:20493726 DOI: https://doi.org/10.1016/j.seizure.2010.04.013
Pohan F, Endarto H, Mangunatmadja I, Gunardi H. Vitamin D levels in epileptic children on long-term anticonvulsant therapy. Paediatr Indones. 2015;55(3):164-70. https://doi.org/10.14238/pi55.3.2015.164-70 DOI: https://doi.org/10.14238/pi55.3.2015.164-70
Edouard T, Glorieux FH, Rauch F. Relationship between Vitamin D status and bone mineralization, mass, and metabolism in children with osteogenesis imperfecta: Histomorphometric study. J Bone Miner Res. 2011;26(9):2245-51. https://doi.org/10.1002/jbmr.413 PMid:21544864 DOI: https://doi.org/10.1002/jbmr.413
Edouard T, Glorieux FH, Rauch F. Predictors and correlates of Vitamin D status in children and adolescents with osteogenesis imperfecta. J Clin Endocrinol Metab. 2011;96(10):3193-8. https://doi.org/10.1210/jc.2011-1480 PMid:21832107 DOI: https://doi.org/10.1210/jc.2011-1480
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Copyright (c) 2023 I Made Arimbawa, Ayu Shintia Shanti (Author)
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